Office hours on high

More than 11 000 medical professionals are registered with the Lufthansa Doctor on Board program. Three ­physicians each describe an incident above the clouds.

Prof. Dr. Günther Faust
General practitioner, Mainz, Germany

Just recently, on a flight to Philadelphia, I treated a flight attendant whose face suddenly swelled up. Known as Quincke’s edema, this kind of thing is usually caused by an allergic reaction, so I gave her an antihistamine injection. The swelling went down, but she was released from duty for the rest of the flight. Most emergencies can be dealt with quite well on board a plane. Once, however, I had to ask the plane to land. That was twenty years ago. An 85-year-old man suddenly complained of a sharp pain in his chest. My diagnosis: angina pectoris, insufficient blood flow to the heart, which in a worst-case scenario can lead to a heart attack. The first thing I did was give him Nitrolingual – to widen the coronary blood vessels. We were flying from Germany to Greece and still had a few hours ahead of us. I was aware, of course, that an unscheduled landing would be very expensive, but in an emergency of this kind, priority is given to a passenger’s health. The captain landed in Vienna, where the man was immediately rushed to hospital. Three days later, he was well enough to be discharged.

It all happened very fast. One minute the person in the seat beside me was completely relaxed, the next minute he was seizing up, he rolled his eyes, clamped his jaw and swallowed his tongue. He could have suffocated. Luckily for him, I was sitting right next to him on this flight from Frankfurt to Mallorca and immediately recognized his symptoms as those of an epileptic fit. I loosened his jaw and tilted his head and neck back so that he could breathe, thus saving his life. I have been a member of the Doctor on Board program since 2009 and in that time have helped quite a few passengers. One of them was a toddler with a very high fever. Why? It was just a relatively harmless case of flu. A Paracetamol suppository from the doctor’s kit soon did the trick. On two occasions, I also had a flight attendant call me over to a diabetic suffering from low blood sugar, who was almost unconscious. In both cases, they had made a mistake with their insulin injections because they had forgotten to factor in the time change. I gave each of them an injection of glucagon to raise their glucose levels and 20 minutes later, they felt fine again.

Dr. Frank Giordano
Radiation oncologist, Mannheim, Germany

Fortunately, very few emergencies actually arise on board, and I have never experienced any myself. More often, passengers suffer from harmless complaints or illnesses. I experienced the same scenario on two different transatlantic flights, one to New York and one to Washington. In each case, a woman collapsed, her legs giving way as she was returning from the lavatory. Other symptoms were nausea and vomiting. Both women had probably eaten something that didn’t agree with them and not drunk enough liquids. They soon felt better once they had taken the simple medication I gave them from the emergency kit. The psychological effect of something like that happening has to be addressed as well. Both women were very agitated, and one of them was afraid the plane might have to land on her account. I introduced myself as a physician and told her everything would be all right – and the woman immediately seemed much calmer. The good news for airline passengers is that doctors travel more often than people in other professions. There is almost always at least one medical professional on board long-haul flights, in particular. What really impressed me on both occasions was how calm the flight attendants remained, immediately passing me the doctor’s kit and handing me the appropriate medication without a moment’s hesitation.

In a medical emergency, time is of the essence whether it arises below or above the clouds. Lufthansa’s Doctor on Board program was set up to provide aid in those all-important first few minutes. Once a physician has signed up to the program, the flight attendants on board always know exactly where he or she is seated in order to be able to locate them as quickly as possible in an emergency. The Lufthansa Doctor on Board program is the largest of its kind, with 11 000 members, many of whom have attended special courses on providing emergency care above the clouds. A doctor’s kit containing professional medical equipment, various instruments and different types of medication is also on board. Physicians receive a mileage credit and a voucher code for their next flight in return for their services, and the airline also assumes all liability for any medical treatment errors.